Im so tired my brain hurts

Tired of cognitive fatigue? Melanie Atkins has a bunch of handy tips

Have you heard this or similar comments? It’s real. It is termed cognitive fatigue. And the good news is there are strategies to help minimise it.

Before I get to the strategies, here is a real life description to help explain what it is like. In an article in The Guardian newspaper Tim Lusherdescribed his experiences following an abscess on the cerebellum, (the part of the brain that controls movement, balance and coordination).

“Ah, the tiredness. That’s another thing everyone talks about. It’s not a tough-week-at-the-office tiredness that you can rally through with a couple of drinks and the prospect of a weekend lie-in. It’s a leaden blanket of exhaustion that sweeps over you – utterly undeniable, non-negotiable and unshakable.”

Cognitive fatigue is common after a brain injury, whether mild, moderate or severe.

The brain is working harder to keep up all its functions, even ones that were once second nature. Eventually it is like an overload button, the brain needs a rest. Without rest it can lead to headaches, or becoming irritable, confused and sometimes increasing problems with behaviour.

What can you do about it? Well even understanding what it is, gives you clues about how you could assist a person manage it. Here are some ideas to get you started.

Below is a list of strategies you might find useful to work with. Decide what might work with the person you are supporting and their network. Just choose the key strategies that might suit. Keep the change manageable for everyone involved.

Balance the daily routine with quiet times, rests, or restful activity; building in whatever rest time the person needs whether a short nap or a longer sleep time.

Help family and friends to understand cognitive fatigue and know that it is as a result of the brain damage, it’s not laziness or deliberate.

Plan ahead to allow opportunity for sleep and rest, program this into the daily plan before fatigue occurs. Work out what time of day is best for activity. We often talk about whether we are a morning, afternoon or evening person, this is important in planning to minimise fatigue.

Allow extra time to complete work that  requires extra concentration and effort. Plan ahead for demanding activities, or when going to special events. Allow for extra rest time and/or quieter routines before and after.

Use aids, equipment, and technology to reduce effort wherever possible. For instance if the person has mobility aids, encourage their use to minimise fatigue.

If helpful see about shorter days for school or work; and with frequent breaks according to need. Encourage saying no to activities or demands that are not important, or that would overly fatigue them.

If there are a number of activities or things to do on a day, work out priorities and tackle the important, or interesting tasks first. As much as possible have familiar routines and surroundings, which reduces the effort and need to concentrate.

Take notice of what factors contribute to fatigue and work out how to manage these as much as possible. This might include the effect of medication, weather, or illness, people, and places.

Be aware that sensory overload can impact on fatigue; situations such as a busy shopping centre with lights and noise. Limit or avoid these situations. Maintain optimal health and fitness. Take care with exercise that it is does not itself cause fatigue. Develop ways to manage fatigue if and when it occurs. Think about at home and when out.

You as a supporter can minimise fatigue by assisting where necessary, and where appropriate, in carrying out tasks, understanding what needs to be done, assisting to maintain agreed rest routines.

When looking at ways to manage fatigue remember it is better for a person to try and manage cognitive fatigue before, rather than after it happens. Plan to prevent rather than manage after fatigue occurs.

Finally remember to always work with the person and their support team when developing any strategies. Each person will have different needs and different responses. This may change over time. Consistency is a key.

Changed Lives New Journeys is a website created by Melanie Atkins for people interested in brain injury, particularly supporters of people with brain injury. Visit www.changedlivesnewjourneys.com for excellent brain injury resources and articles.

Article Via Synapse Bridge Magazine Volume 19